Internal medicine resident Dr. Carolina Duran performs a dental exam on an equine patient at the WCVM Veterinary Medical Centre. Photo: Christina Weese.

Regular dental checkups health investment

Everybody knows the importance of regular dental checkups when it comes to human health, so it should come as no surprise that horse health is just as dependent upon regular oral health checks.

Dr. James Carmalt, a professor of equine surgery and a specialist in equine dentistry at the Western College of Veterinary Medicine (WCVM), recommends that horses receive routine oral health checks every six months or every year.

"Horses don't tend to show a lot of pain and discomfort, so they can have horrible teeth and you won't know just by looking at them," says Carmalt, one of only 10 board-certified equine veterinary dental specialists in North America.

"You may not have to do anything, but it's important to look — a regular check can pick things up early."

For a complete oral exam, Carmalt sedates his patient so he can use a full-mouth speculum. This tool opens up the horse's mouth completely and allows Carmalt to examine and feel every single tooth while he checks the chewing surface for open pulp chambers. He also uses a mirror and dental picks to check the chewing surfaces and to look for any areas of feed retention.

In addition to learning the animal's age, Carmalt has some routine questions for the owner: Has the horse had any nasal discharge? Has there been any systemic disease in the herd? Where is this horse in terms of herd dynamics? Have you seen this horse dropping feed? Does the horse appear tender when you bridle it or have you had problems on the saddle?

While all of this information is important, the horse's age is particularly significant since the incidence of disease in the mouth increases with age. By the age of four or five, horses have the maximum length of teeth in their mouths that they're ever going to have, but their teeth continue to erupt until the animals essentially run out of tooth in their late twenties or early thirties.

Wave mouth is a common problem associated with age that results from the teeth erupting at different rates, often resulting in overly tall teeth on the bottom and slightly shorter teeth on the top.

While rasping or floating down the taller teeth is the usual remedy, there's only a certain amount of tooth to work with, and it's not going to come back. Tooth loss is common in older horses, but it often leads to more problems.

"It's not the tooth that's lost we're concerned about, it's the underlying teeth," Carmalt explains. "If you remove the upper tooth, now there's no backstop for the underlying tooth — the lower tooth that's in the same position on the arcade. So it super-erupts and you end up with a wave mouth or a tall tooth that can create problems elsewhere."

Diastemata or abnormal spaces between cheek teeth are also a common condition, particularly in older horses. Because these spaces fill up with feed, they can lead to periodontal disease. Veterinarians can alleviate gum recession by flushing out the feed or by using perioceuticals, drugs specifically developed to treat the bacterial infection and promote gum healing.
"You may not have to do anything, but it's important to look — a regular check can pick things up early."

The oral exam is also a chance for the veterinarian to determine whether floating is needed to smooth out the sharp enamel points that can form on the horse's cheek teeth, usually on the outside of their upper teeth or on the inside of their lower teeth. These sharp edges can injure the soft tissue of the cheeks.

While an average oral exam takes about 10 minutes, the floating or rasping process usually requires about three minutes with power tools. Carmalt compares floating to the cleaning process that humans undergo during their regular dental checkups.

"During your regular dental checkup, the dental therapist cleans your teeth, but the primary goal is for the dentist to have a good look at your mouth. It's the same for us. I check that mouth backwards and forward, and I spend more time on my oral exam than I do on actually rasping the teeth."

Miniature horses tend to have more oral health problems because of their smaller mouths, but otherwise, Carmalt says there are no specific dental issues associated with specific breeds.

However, performance animals, particularly because of the way they're managed, may end up having more dental problems.

"The good Lord designed horses so that if you feed them long-stemmed fibre or hay or you keep them extensively out on the grass, you'll have fewer problems than if you have them in a barn," says Carmalt.

"For one thing, when they chew the grass or the hay, the lower jaw is moving so much more and its lateral motion knocks off those sharp edges that often require floating."

Over the last 10 years, information about equine dental care has grown in leaps and bounds with countless new publications about basic anatomy and physiology, endodontics and periodontics. And as horse owners realize the significance of oral health to their animals' overall health and performance, they're more likely to seek dental care.

Carmalt emphasizes the importance of consulting veterinarians who have background training in anatomy and physiology as well as access to the sedative drugs necessary for them to perform the full mouth oral exam with all of the required equipment.

"We're learning more and more so we can give the best possible care," says Carmalt. "Sometimes I'll look in a horse's mouth and find out that things are great. That's not wasted money and time. That's an investment. And if I do find something that needs to be fixed now, it's going to be a heck of a lot cheaper and more successful if I deal with it now and not in five years."

Reprinted with permission from the WCVM Equine Health Research Fund (www.ehrf.usask.ca).
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